Clinical Laboratory – CDT04209CLINICAL LAB- specimen(2)
Read the complete lesson in an organized slide-by-slide format. This topic contains 33 learning sections from the source presentation.
LESSON CONTENTS — 33 SECTIONS
SESSION 2: SPECIMENSPART ONE
Learning Objectives
- Identify the types of specimens
- Identify different materials used for collecting blood and urine specimens
- Identify the sites of collecting blood specimens
- Describe specimen storage techniques for different rapid tests
Explain the criteria of good specimen
Identify different types of containers for sharps, infectious and non infectious materials
Explain the significance of safety measures when collecting specimens
Learning Objectives
DEFINITION OF TERMS
Specimen
Is a small sample or part taken to show the nature of the whole, such as a small quantity of urine for urinalysis, or a small fragment of tissue for microscopic study
Types of specimens
Routine specimens
Are specimens which performed regularly in the laboratory
Non-routine specimens
are specimen which are not performed regularly in the laboratory.
Examples are CSF, Ascitic fluid, pleural fluid etc
TYPES OF ROUTINE SPECIMEN
Routine specimens includes;
Stool
Is a waste material excreted from the intestines
Urine
Is a waste material/fluid excreted from the kidney
Blood
Blood is the fluid that circulates in the blood vessels of the body. Blood consists of plasma and cells floating within it.
Sputum
Is a substance that is brought up from the lungs and airway when a person coughs or spits. It is usually a mixture of saliva and mucus
Pus
Is a thick white or yellowish fluid that forms in areas of infection such as wounds and abscesses. It is constituted of decomposed body tissue, bacteria or other micro organisms that cause the infection, and certain white blood cells.
TYPES OF ROUTINE SPECIMEN
Different materials used for collecting blood and urine specimens
Methods of collecting routine specimens includes
Individual collection
Assisted collection such as blood
Different materials used for collecting blood
Specimen containers
Specific container depends on which test will be done
Correct specimen bottle can be identified by the color of its top or the label they carry
Vacutainer tubes identified by the label on it
Tourniquet
Needles and syringes
Gloves
Aprons or laboratory coats
Alcohol swabs
Cotton Gauze/Wool
Different materials used for collecting blood
Hand towels/tissue paper (Preferably disposable)
Waste disposal containers
Sharps bin (For disposal of sharps)
Infectious waste bin (For disposal of non sharp infectious materials)
Non infectious bean (For disposal of non infectious materials)
Marker pen for marking or labelling of specimen and forms
Disinfectant (e.g. Jik, Clorox)
Antiseptic for hand washing
Bandages or plasters
Materials required to prepare for the examination of urine
Gloves
Biohazard waste containers
Liquid soap
Register and Request forms
Urine specimen container
Centrifuge machine
Test tubes
Slides
Cover slips
Microscope
Pasteur pipettes
Hand towels (preferably single use
Materials required to prepare for the examination of urine
Sites for Collecting Venous and Capillary Blood
Venous blood is collected in the following sites (veins)
Median Cubital Vein. (NO.1)
A superficial vein, most commonly used for venepuncture. It lies over the cubital fossa and serves as an anastomosis between the cephalic and basilic vein
Cephalic vein. (NO.2)
Shown in both the forearm and arm, it can be followed where it empties into the axillary vein
Basilic Vein.(NO.3)
Seen in the forearm and arm, it dives to join the brachial; best area for venepuncture is antecubital fossa area
Slide 15
Collection of capillary blood
Capillary blood is collected from the side of the finger in adults and children. Avoid the tip of the finger as it is very sensitive. In infants, collect capillary from the side of the heel.
Caution on Heel pricking Technique
Infant heels are appropriate for blood collection until approximately 6 months to one year
Never exceed 2.4 mm in puncture depth
Never puncture the posterior curvature of the heel or the arch of the foot
Never use sites previously punctured, bruised, swollen or red in color
Never puncture the heel more than twice for any one collection
Heel pricking Procedure
Wipe away the first drop of blood
Ease thumb pressure and apply intermittent pressure. Avoid milking and scraping
Follow recommended order of draw
When blood collection is complete, clean area, apply pressure.
Never apply band-aid under the age of two
Label specimens immediately after the draw; never before
Types and Methods of Urine Collection
First urine.
A first morning urine sample is used for detection of urinary tract infection especially mycobacterium
Procedure of collecting first urine
Provide the patient with a clean, dry container.
Instruct the patient to provide about 20 ml of urine voided immediately after arising in the morning.
The patient should label the container with their name and date of collection
2. Midstream urine
Midstream urine
is used for microscopy and culture to investigate bacterial infection of the urinary tract
Procedure of collecting midstream urine
Provide the patient with a sterile container.
Instruct the patient to pass a small amount of urine into the toilet. This ensures that any organisms or cells in the urethra are flushed away.
Types and Methods of Urine Collection
Instruct the patient to provide about 20 ml of urine in the container.
Instruct the patient to pass the remaining urine in their bladder into the toilet.
The patient or the laboratory technician should label the container with the patient name and date of collection.
Types and Methods of Urine Collection
SPECIMEN STORAGE
Although samples do not need to be kept refrigerated or frozen during transport, it is advisable to store them in a cool place and transport them to the laboratory as soon as possible
Specimen for RDTs are stored at 2-8o C for short terms and for -20oC for long terms.
Containers for Laboratory Investigations
Container – Is a carrier of specimen
Types of containers
Wax carton
Wax cartons are made in the laboratory using cardboard and a stapler
These cartons can be used only once for sputum collection in the laboratory
Universal bottle
These are glass or plastic bottles with screw caps have the capacity of 25 ml
CONT…
Plastic container with cap
Are made of plastic materials
Are containers with different capacities
Bijou bottle
These are glass or plastic bottles with screw caps
Have the capacity of 5ml
3. Terminal urine
Terminal urine
A terminal urine sample is used to demonstrate ova of Schistosoma haematobium
Procedure of collecting terminal urine
Provide the patient with a clean container and tell the patient to.
Void most of the urine into toilet
Collect last portion of urine to the container
Secure the lid of container immediately
Types and Methods of Urine Collection
Criteria of a good specimen
Sufficient quantity of specimen
Right container
Condition of the specimen Is ideal
Complete and full filled request form
Labelled specimen
Adequate and short transport time of a specimen
Significance of Containers
Differentiates tests
Stores specimens
Prevents infections
Identifies type of specimens
Helps to handle and transport the specimens
Easier to write patient information
Different types of containers for sharps, infectious and non infectious materials
Waste category
Type of waste
Colour of receptacles and liner
Non-infectious waste
Paper,packaging materials,
Plastic bottles,food remains,boxes,cartons
Black/blue
Infectious waste
Used gloves,dressing materials,specimen containers,infusion packages,catheters,urinal bags
yellow
Highly infectious waste
Anatomical waste,blood,body fluids,pathologivcal waste,culture materials,stocks,petri dishes
Red
Sharps waste
Use syringes and needles,surgical blades,scalpels,broken glass
Safety box
Different types of containers for sharps, infectious and non infectious materials
Significance of safety measures when collecting specimens
Evaluation
Define routine specimens and non-routine specimen.
List five routine specimens
List three sites (Veins) for collection of venous blood
Define non routine specimens
List five non routine specimens
References
- F.J. Baker, R.E. Silverton (2001): Introduction to Medical Laboratory Technology, 7th Edition, Oxford University Press.
- Monica Cheesbrough (1981): Medical Laboratory Manual for Tropical Countries Volume I, 2nd Edition Butterworth & Co. (Publishers) Ltd; and
- Monica Cheesbrough (2002): District Laboratory Practice in Tropical Countries Part 1 & 2, Cambridge University Press.
- WHO(2003) Manual of basic laboratory techniques for health laboratory.2nd ED. World Health organisation-Geneva
- WHO(1980) Manual of basic laboratory techniques for health laboratory.1st ED. World Health organisation-Geneva
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